红细胞分布宽度与血小板计数比值、中性粒细胞计数与血小板计数比值对严重烧伤患者的预后评估
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Early platelet change trend and clinical prognostic evaluation value of NPR and RPR in patients with severe burns
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    摘要:目的?观察严重烧伤患者的血小板计数(PLT)变化趋势、红细胞分布宽度(RDW)/PLT比值(RPR)、中性粒细胞计数(N)/PLT比值(NPR)水平及其对预后的评估价值。方法?选取2017年1月至2019年8月杭州市江干区人民医院收治的烧伤面积大于总体表面积30%的患者101例作为研究对象,记录入院后PLT开始减少的时间、PLT达到最低值的时间及最低值平均数、首次切削痂的面积、手术治疗前及手术治疗后的PLT变化情况。于患者烧伤后第3天检测血常规,根据RDW、N、PLT计算RPR、NPR并进一步统计分析。结果?PLT开始降低时间为(3.13±0.74)d,PLT最低值出现时间为(6.68±0.51)d,PLT最低值为(204.55±17.26)×109/L,PLT平均在第(11.59±1.34)天开始恢复。Spearman秩相关性分析显示,PLT最低值与烧伤总面积、Ⅲ度烧伤面积呈负相关(相关系数为-0.304、-0.364,P均<0.05);多元线性回归分析显示,烧伤面积越大、手术切削痂的面积越大、未使用生长激素均是PLT平均值降低的主要影响因素;应用Kaplan-Neier分析显示,烧伤后第3天RPR、NPR的高低数值与患者生存率相关。结论?烧伤后第3天RPR和NPR可作为严重烧伤患者预后判断的辅助指标。

    Abstract:

    Objective:To study and analyze the platelet change trend, and clinical prognostic evaluation value of NPR and RPR in patients with severe burns. Methods:A total of 101 patients with burn area greater than 30% of the total surface area, admitted in our hospital from January 2017 to August 2019, were selected as the research objects. The time when the platelet count began to decrease after admission, the time when the platelet count reached the minimum value, the minimum value, the mean value, the area of the first eschar excision or shaving, and changes in platelet counts before and after surgery were recorded. On the 3rd day after the burn, a routine blood test was performed to detect the index values of the red blood cell average distribution width (RDW), neutrophil count (NEUT), and platelet count (PLT), and then the relevant values of RPR and NPR were calculated.Results:The Spearman rank correlation analysis revealed that the minimum platelet count value was positively correlated with the total burn area and burn area of Ⅲ degree. multiple linear regression analysis showed that the main influencing factors of plateletreduction were the larger burned area, the larger area of the eschar excision or shaving, blood transfusion, and unused growth hormone. Kaplan-Neier analysis showed that the values of RPR and NPR on the 3rd day after burn were correlated with patient survival rate.Conclusion:On the 3rd day after burn injury, RPR and NPR can be used as independent risk factors for predicting the prognosis and death of severely burned patients. The combination of two indicators to assess the survival and prognosis of patients after injury can further improve the evaluation accuracy.

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叶慧,张钧,谢鑫友.红细胞分布宽度与血小板计数比值、中性粒细胞计数与血小板计数比值对严重烧伤患者的预后评估[J].临床检验杂志,2021,39(1):40-42

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  • 收稿日期:2020-06-07
  • 最后修改日期:2021-02-09
  • 录用日期:2020-10-09
  • 在线发布日期: 2021-03-24
  • 出版日期: 2021-01-28
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